HALOPERIDOL AND ATTENTIONAL LEARNING IN AUTISTIC CHILDRE

这项申请的目的有两个：(1)批判性评估 纳曲酮治疗自闭症的疗效和安全性 它对行为症状和学习的影响。40个孩子， 年龄2至7岁，患有DSM-III-R自闭症， 婴儿发病将进入平行分组设计，双人- 纳曲酮的盲法安慰剂对照研究，持续6周。 在两周的安慰剂基线之后，儿童将被随机 分配给纳曲酮或安慰剂3周，然后 最后一周服用安慰剂。剂量范围为0.5至1.0 Mg/kg/天；纳曲酮稳态血药浓度 与临床反应相关，受试者将被多次评级 在各种主观和客观的尺度和意志上的评分者 参与戏剧性的条件反射，学习歧视 在自动化实验室中完成任务。这项研究对于评估 每天服用纳曲酮的效果，这种药物有 在自闭症儿童的开放、急性药物试验中有效。 氟哌啶醇的替代疗法，最常用的 需要药物治疗的自闭症儿童的药物治疗， 是因为与神经镇静剂相关的高发病率 运动障碍。(2)我们也希望继续我们的长期合作 氟哌啶醇治疗孤独症儿童的前瞻性研究 对行为症状、智力功能、发育的影响， 刻板印象和与毒品有关的运动障碍。将有30个新孩子 登记并添加到样本中。这项设计需要一个首字母 氟哌啶醇治疗6个月后的基线评估，然后 服用安慰剂1个月。需要进一步治疗的儿童 然后开始另一个7个月的用药周期。自闭症儿童 属于基线发病率较高的患者群体 与抗精神病药物无关的异常运动(刻板印象) 行政管理。特别是在嘴巴和舌头方面， 很难，有时甚至不可能区分刻板印象 无基线的抗精神病药(戒断)运动障碍 评估。一个同样具有重大临床意义的研究问题 重要的是要区分这两种类型的 动静。在我们的前瞻性研究中，每个受试者都有稳定的 多个评分者对刻板印象的基线评估，分3级 在固定的时间重复刻度和录像。我们的研究是 在评估长期治疗的效果方面独一无二 并阐明氟哌啶醇的产状、地形和影响因素 影响抗精神病药相关的运动障碍的发病，一个主要的 公共卫生问题。我们现在有一个足够大的样本 仔细研究儿童，以便对儿童的 随着时间的推移，收集了许多衡量标准。

The aims of this application are two-fold: (1) To critically assess the efficacy and safety of naltrexone in the treatment of autism: its effects on behavioral symptoms and on learning. 40 children, ages 2 to 7 years, with DSM-III-R diagnoses of Autistic Disorder, Infantile Onset will be entered in a parallel groups design, double- blind placebo-controlled study of naltrexone lasting 6 weeks. Following a 2-week placebo baseline children will be randomly assigned to either naltrexone or placebo for 3 weeks followed by a final week on placebo. Dosage will range from 0.5 to 1.0 mg/kg/day; steady state plasma concentration of naltrexone will be related to clinical response, subjects will be rated by multiple raters on a variety of subjective and objective scales and will participate in an operant conditioning, learning discrimination task in an automated laboratory. This study is necessary to assess the effects of daily administration of naltrexone, a drug which has been effective in open, acute drug trails with autistic children. Alternative treatments to haloperidol, the most commonly used medication with autistic children who require pharmacotherapy, are sought because of the high incidence of neuroleptic-related dyskinesias. (2) We also wish to continue our long-term prospective study of haloperidol in autistic children: to assess its effects on behavioral symptoms, intellectual functioning, growth, stereotypes and drug-related dyskinesias. 30 new children will be enrolled and added to the sample. The design calls for an initial baseline assessment followed by 6 months on haloperidol and then 1 month on placebo. Children requiring further treatment with medication then begin another 7-month cycle. Autistic children belong to a population of patients who have high baseline rate of abnormal movements (stereotypies) unrelated to neuroleptic administration. Particularly in the area of mouth and tongue, it is difficult and at times impossible to differentiate stereotypies from neuroleptic (withdrawal) dyskinesias without a baseline assessment. A research question which is also of great clinical importance is to differentiate between these two types of movements. In our prospective study, each subject has a stable baseline assessment of stereotypies by multiple raters, on 3 rating scales and videotaping repeated at fixed times. Our study is unique in assessing the effects of long-term treatment of haloperidol and to clarify the occurrence, topography, and factors affecting the onset of neuroleptic-related dyskinesias, a major public health concern. We now have a large enough sample of carefully studied children to permit statistical analyses of the many measures collected over time.